(265) - A brief demographic and psychological portrait of VA patients evaluated as candidates for spinal cord stimulators

Abstract

Spinal Cord Stimulation (SCS) via externalized or implantable systems has been available since the 1960s. Interestingly, the degree of pain relief and other forms of benefit obtained from SCS has been noted to be highly idiographic. Since the advent of Melzack and Wall's Gate Control Theory in 1965, research on the impact of psychosocial variables on pain perception has been both prolific and fruitful, yielding empirical support for a number of psychological interventions for pain. Operating in a Veteran Affairs Medical Center environment, the current study was aimed at building a demographic and psychological profile of Veterans referred as candidates (N = 114) for SCS implantation. Psychological measures were selected based on factors identified in previous research (in primarily non-Veteran populations) as having an effect on SCS efficacy and/or treatment outcome. Thus Depression, as measured by Patient Health Questionnaire (PHQ-9; N = 112); Catastrophizing, as measured by the Pain Catastrophizing Scale (PCS; N = 112); and Quality of Life, as measured by World Health Organization Quality of Life questionnaire (WHOQOL; N = 113) were included. Additionally, PTSD symptoms were measured using the Posttraumatic Stress Disorder Checklist (PCL 5; N = 77) as studies have shown up to 48% of Veterans with PTSD also report having chronic pain. Standard measures of central tendency and subscale scores within the PCS and WHOQOL were derived. Relatedly, 28% of all Candidates scored in the Moderate range for Major Depression on the PHQ-9; 51% in the “high risk for catastrophizing” range on the PCS; and 38% in the positive range for PTSD on the PCL 5. Data collection is currently underway with patients advancing to the SCS trial and permanent implant stage with focus on identification of factors responsive to SCS intervention and with prognostic potential for SCS efficacy.